The NRMP Residency Match process just ended for this year and the most common question I’ve received in the Ask RookieDoc survey is “I didn’t match… What should I do now?” While I can provide some general advice about what to do if you didn’t match, it really depends on your personal situation. There is no one-size-fits-all advice for people who didn’t match. For some of you, it’s your scores, for others it’s communication skills, and for others it’s something else.

This, of course, is not the end of the world. But it will require some work and strategy.

The big picture steps:

Scramble process

Honestly assess the potential reasons for not matching

Set goals

Monitor for openings (ongoing)

Improve your credentials (ongoing)

Re-apply

So let’s look at these things one-at-a-time:

Scramble process: I assume you are doing this now… If so, remain active, and at the same time (most importantly) be patient. These 2 days of scrambling are loaded with rejections. Don’t get a few and then stop… keep plugging along.

Assessing your reasons for not matching: This is a 2 part process… 1 internal & 2 external. The internal self-assessment is to take a look at your application, your skill set, your CV, your scores, relationships, etc.

Before reviewing your stuff… ask this very important question: What does your gut feeling tell you – Why didn’t you match?

Then while reviewing these things above, put yourself in the mind of someone reviewing your application. Why should they take you? What about you is easy to sell to them? What about you would be a red flag?

Take a look at the relationships you’ve developed at various institutions – everyone from attendings to residents to nurses to residency program coordinators & secretaries. Ask yourself if there were any that were great. If so, what made them great? Were there any that didn’t go so well? If so, why not?

Take a look at your CV. What’s great about your CV? What’s not so good? What could be better?

How about the places you’ve done rotations… Which ones did you perform well in? Which ones not so well? Why? What relationships can continue to be nurtured now?

The external portion is to have someone examine some of these things for you. Ask the programs you thought you had a good chance at for some insight into why you were not chosen and what you can do now to improve your application. Send me your CV and personal statement for review (this is for RookieDoc members only). I can take a look at them. (Although I cannot offer immediate help for this application year, I can provide some helpful insights for what needs to be improved for next time.) But also, have others review them and give you feedback (just make sure they’re honest & not just trying to avoid the hard conversation – it’s not easy to tell someone about their weaknesses).

Set goals: Now don’t blow this off. Setting goals is ultra-important… and not only that… write them down. Even tell some people (friends/family) your goals for this upcoming year. They’ll help you stick to them.

Your goals should specific with specific dates. “I want to get a research position at XYZ University with Dr. ABC by April 30th” “I will have 3 people review my CV by April 10th” “I will get a job in XYZ hospital as a phlebotomist by May 1st” … or whatever you think will improve your application for next time.

Monitor for openings: The best way to monitor for openings is to be involved in the places near where you have the best shot at getting in. Sometimes people have visa problems when they get started & programs can wait only so long before they find a replacement. Sometimes it just doesn’t work out for one reason or another – behavior problems, etc. If you have befriended someone on the inside, they can let you know that something has happened in the program.

Another way to monitor for openings is to use services like FindAResident (https://services.aamc.org/findaresident/ ). Some programs even send out notice on Twitter, so you should have a Twitter account and follow them.

So as you’re carrying out your plan/fulfilling your goals, if a position opens up, you pounce on it.

Improve your credentials: This possibility is endless… most people think research is the only way to go. Although research is good, maybe even great, it really depends on what you identified in #2 (your assessment of why you didn’t get in). Sure research may be good for some, but if you find that your reason for not getting in is communication skills – then research won’t help, but maybe being a phlebotomist or an EKG tech would. You see? So, whatever your reason for not getting in was, you need to be able to counter that objection next time.

Another way to improve your credentials is to “strengthen your strengths”. If there’s something that you’re particularly good at that is a valuable skill, then maybe you take that skill from good to great. Maybe you work in research during the day, but work on writing a book at night, or whatever.

Again it all depends on #2.

Re-Apply: Map out the important dates for next year now. Get your papers/files in order now. Your re-application starts now. Along the way, you may have an opportunity to jump in if a spot opens up. Have all of your stuff ready for a moment’s notice.

Again, I’m sorry that you didn’t get in, but I hope this advice helps. Send me your CV & your most recent personal statement if you want me to look at them. (again… RookieDoc members only)

Looking for med students who didn’t match for an article I’m writing. I’m looking for those who didn’t match in the past to find out what they did after. Also looking for people who didn’t match this year. I’m at ankitar@kff.org.

Be a phlebotomist? How in the world are you supposed to start paying off loans on $11 an hour? Who in the world would even hire someone like that for phleb? Why would anyone want to bother with coughing up yet even MORE tuition to get a cert like that? Horrible advice.

No one is saying become a phlebotomist… The advice is to set specific goals. For some, it is to do other things WHILE doing observerships, or research, or in addition to another course of study. In many places you need exposure. I know several people who were EKG techs, phlebotomists, and even just hospital volunteers while they did research, applied the following year & got in.